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Lesbian, gay, bisexual and transgender tobacco use

Institution: Kaiser Foundation Research Institute
Investigator(s): Elisabeth Gruskin, DrPH
Award Cycle: 2004 (Cycle 13) Grant #: 13RT-0084 Award: $302,119
Subject Area: Epidemiology
Award Type: Research Project Awards

Initial Award Abstract
The little research that has been conducted on the smoking of lesbians, gays, and bisexuals has found that they smoke more than heterosexuals (straight people), however there are many problems with this research. First, most of the research has studied lesbians, gays and bisexuals in separate studies from heterosexuals and can not make direct comparisons because the methods and the questions are different. Also, participants in the studies often have different characteristics--such as age or education-- which can affect whether or not they are likely to smoke. For example, in the LGBT studies, the participants are often younger than the participants in the heterosexuals studies, and therefore more likely to smoke because they are younger, not because they are gay or lesbian. Researchers also fail to ask questions that may be important in understanding the smoking of this population such as questions on stress, discrimination, or participation in the LGBT community.

We have a unique and timely opportunity to compare the tobacco use, cessation and second hand smoke of the LGBT population in California to that of the general population. The Tobacco Control Section (TCS) of the California Department of Health Services conducts a California Tobacco Survey (CTS) approximately every 3 years. In 2002 they contracted with Field Research Corporation to conduct a telephone survey of gays, lesbians, bisexuals and transgendered people using some questions identical to the CTS so that direct comparisons can be made between the results of the LGBT and CTS surveys. They also asked additional questions important to LGBT individuals. Approximately half of the 2,100 participants were surveyed at the time of this grant submission.

While TCS is able to fund research related to the general smoking prevalence and basic estimates, an analytic study such as this one falls outside of its budgetary scope. We are therefore applying for additional funding from TRDRP to conduct sophisticated analyses to help us understand better the tobacco use of lesbians, gays, and bisexuals. Specifically we will: 1. Compare the current and lifetime tobacco use of lesbians, gays, bisexuals and heterosexuals 2. Compare the smoking cessation of lesbians, gays, bisexuals, and heterosexuals 3. Compare the second hand smoke exposure of lesbians, gays, bisexuals and heterosexuals 4. Within LGBTs, compare the relationship between current and lifetime tobacco use, smoking cessation, second hand smoke and a. Individual characteristics (age, sex, education, race/ethnicity, partnership status, outness, internalized homophobia, depression, alcohol use, drug use) b. Social predictors (bar attendance, participation in the gay community, discrimination, stress) c. Environmental predictors (exposure to tobacco advertising and promotion, smoking in home/work) d. Smoking cessation assistance (medication, counseling, education).

We will, along with publishing the results of the analyses in peer-reviewed journals, write reports to be circulated to non-profit organizations, present at LGBT and general conferences and create educational materials.